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A controversy in the dental community currently exists concerning the success rate of root canal therapy when compared with that of implant treatment. Saving your natural tooth should always be your first choice when dental care is needed. Nothing, not even the most advanced bridges and implants, can truly replace your natural tooth. If your dentist recommends extracting your tooth, ask if it can be saved with an endodontic procedure, also known as root canal treatment. Endodontic treatment removes the injured pulp (soft inner tissue) of your tooth and fills and seals the space. Your tooth is then restored and can function just like any other tooth for the rest of your life, ensuring comfortable chewing and a natural appearance.
If your tooth cannot be saved—and some cannot—you may consider replacements such as a bridge or dental implant. Your options may depend upon the condition of surrounding teeth and bone structure. Dental implant procedures can be complex, costly and they often require several visits and up to a year of healing before the procedure can be completed.
At the heart of the controversy is the definition of success. Dental implants are very valuable in the replacement of missing teeth; however, their success is determined quite differently than that of root canal therapy. With implants, success can have many different definitions, including those that would be considered by many clinicians and patients as failure. The definition of success with root canal therapy is generally defined as a functional tooth with no symptoms and no evidence of disease.
That being said, the success rates of both procedures are very comparable, even with the inaccuracy of the definitions. The goal of root canal therapy is to preserve your natural teeth, whereas implants are more geared toward replacing missing teeth or replacing teeth which are not amenable to root canal therapy.
Having root canal therapy does not prevent you from having implant therapy if needed in the future; however, implant therapy does preclude you from any procedure that would maintain your natural tooth.
Dr. Leffingwell is available to consult with you and your dentist in determining the right course of treatment for you.
Nothing is as good as your natural tooth!